Omudhome Ogbru, PharmD

Dr. Ogbru received his Doctorate in Pharmacy from the University of the Pacific School of Pharmacy in 1995. He completed a Pharmacy Practice Residency at the University of Arizona/University Medical Center in 1996. He was a Professor of Pharmacy Practice and a Regional Clerkship Coordinator for the University of the Pacific School of Pharmacy from 1996-99.

Jay W. Marks, MD

Jay W. Marks, MD, is a board-certified internist and gastroenterologist. He graduated from Yale University School of Medicine and trained in internal medicine and gastroenterology at UCLA/Cedars-Sinai Medical Center in Los Angeles.

GENERIC NAME: metoclopramide

DRUG CLASS AND MECHANISM: Metoclopramide is a "prokinetic" drug that
stimulates the muscles of the gastrointestinal tract including the muscles of
the lower esophageal sphincter, stomach, and small intestine by interacting with
receptors for acetylcholine and dopamine on gastrointestinal muscles and nerves.

The lower esophageal sphincter, located between the esophagus and the stomach,
normally prevents reflux of acid and other contents in the stomach from backing
up into the esophagus. In patients with gastroesophageal reflux disease (GERD),
a weakened lower esophageal sphincter allows reflux of stomach acid into the
esophagus, causing heartburn and damage to the esophagus (esophagitis).
Metoclopramide decreases the reflux of stomach acid by strengthening the muscle
of the lower esophageal sphincter. Metoclopramide also stimulates the muscles of
the stomach and thereby hastens emptying of solid and liquid meals from the
stomach and into the intestines.

In some patients, particularly those with
diabetes, damage to nerves in the stomach can interfere with function of the
muscles and cause delayed emptying of the stomach, resulting in nausea,
vomiting, a sense of abdominal fullness and distention, and heartburn (diabetic
gastroparesis). Metoclopramide can be effective in relieving the symptoms
related to diabetic gastroparesis by stimulating more rapid emptying of the
stomach as well as decreasing the reflux of stomach acid into the esophagus.
Dopamine receptors on nerves in the brain are important in producing nausea.
Metoclopramide interacts with the dopamine receptors in the brain and can be
effective in treating nausea. The FDA approved metoclopramide in June 1985.